Approach to Care

Introduction

The global sustainable growth of morbidity and mortality caused by the malignant tumor and the associated significant social and economic losses make the cancer treatment one of the most urgent problems of modern health care sphere. Despite the reduction in mortality rate for some tumors, the overall mortality rate from cancer is characterized by a slow but steady increase. At the same time, the challenges facing cancer treatment departments in all countries are complicated that now even the developed states are unable to solve the problem of the prevention and treatment of malignant neoplasms. Therefore, one of the most effective ways to solve this problem is the cooperation the combined efforts of all state agencies in the conduction of the cooperative research and the development of effective programs for the prevention and treatment of cancer. The paper investigates the approach to the care of cancer and gives the recommendations on care depending on the stage of the disease.

 
 

Diagnosis of Cancer

Oncology is the branch of medicine that investigates the causes, mechanisms of development and clinical manifestations of cancer and tumors, and develops the methods of diagnosis, treatment, and prevention. A tumor is an uncontrolled growth of the poorly differentiated cells (skin cells, connective tissue or blood cells) leading to the replacement of normal tissues of various organs, their destruction, together with the intoxication by the products of tumor metabolism, depletion of life-support systems, and death.Thus, the treatment of cancer requires both healing the disease itself and combatting the side effects that appear in the process.

The source for the uncontrolled growth of poorly differentiated cells is formed by specific tumor mutations that occurred in the normal cells of the cambium. These mutations lay in the conversion of proto-oncogenes available in each normal cell into oncogenes that encode the production by the cells of completely different proteins and enzymes, defining the new properties of these tumor cells. Specific mutations in tumor cells appear due to the influence of certain chemicals (chemical carcinogens), physical factors (radiation, microwave), and biological factors (oncogenic viruses). Tumor cells initially form a solitary (single) locus. In future, it grows locally, and separate cells are spread with the flow of lymph and blood and give rise to metastasis. Due to this fact, it is possible to determine two stages of the disease, with the development of metastasis and without it.

The modern treatment of cancer patients is a complex problem. To resolve the problem, it is necessary to combine the efforts of surgeons, radiation specialists, chemotherapists, psychologists, and nurses. Such an approach to the treatment requires the nurse to carry out different tasks: the introduction of drugs (chemotherapy, hormone therapy, biotherapy, painkillers, etc.) according to the recommendations of a physician; participation in the creation diagnosis and the treatment process that appear within the treatment of complications; provision of psychological and psycho-social care to patients; educational work with the patients and their family members; participation in the scientific research.

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Stages of Cancer

While discussing the stages of the cancer, one should assert that various physicians as well as theorists approach this issue in different way. Following this, the features of the organism that are attributed to the cancer differ a lot. Yet, within the framework of this paper I have identified four basic stages of cancer.

The first stage is frequently referred to as zero-stage when the cancer is in situ which means in place. It is located in the human body; yet the tissues have not yet started to spread. At this stage, the cancer can be curable by the ordinary medication and the chances for the full recovery are rather high. The entire tumor is usually removed from the body with help of surgical services.

The first stage respectively provides for the small cancer or the tumor that has not deeply grown into the tissues that develop within the body. The physicians relate this phrase as early-stage cancer. It does not spread to the lymph or other parts of the body. Again, it can be cured by the removal of the tumor with surgery.

The second and third stages are often approached together since they basically provide for the same interventions and treatment. These tumors usually grow deeper into the tissues and form the uniform creation with them. At this stage the cancer also hits the lymph leaving the other organs of the body relatively unaffected.

Finally, the fourth stage of the cancer development is considered to be the least curable since the tumor has connected with the tissues as well as spread the metastases. At this stage the cancer spreads to the entire body. The chances for the curing of the cancer are relatively low. The treatment includes the chemotherapy with the re-occurring

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Adverse Reactions

The development of adverse reactions caused by the use of anticancer drugs creates certain problems for the patient and medical personnel that provides the care. One of side effects is the hypersensitivity reaction, which can be acute or delayed. An acute hypersensitivity reaction is characterized by the appearance of shortness of breath of patients. There may take place wheezing, a sharp drop in blood pressure, tachycardia, redness of the skin. The side effects appear at the first minutes of the drug perception. In this case, a nurse should immediately stop the injection of the drug and inform the physician. So that not to miss the beginning of the appearance of these symptoms, the nurse should constantly monitor the condition of the patient. It is necessary to control blood pressure, pulse, respiratory rate, skin condition, and any other changes of the state of health. These procedures should be carried out at each injection of anticancer drugs. The delayed hypersensitivity reactions are symptomized by sustained hypotension and rash. In this situation, a nurse should reduce the speed of the drug injection and inform the physician.

Among the other side effects that may take place under the influence of anticancer drugs, there take place neutropenia, myalgia, arthralgia, mucositis, gastrointestinal toxicity, alopecia, phlebitis, extravasation. Neutropenia is one of the most common side effects, which is accompanied by the reduction in the number of leukocytes, thrombocytes, neutrophils; it is accompanied by hyperthermia and the combination with an infectious disease. Normally, it takes place on the seventh-tenth day after chemotherapy and lasts from five to seven days. It is necessary to measure the body temperature twice a day. To reduce the risk of infection the patient should refrain from excessive activity, to avoid contact with patients, who suffer from respiratory infections, not to visit places with a high density of people.

Leukopenia is a dangerous development of severe infectious diseases, depending on the severity of the patient's condition. The treatment requires the appointment of broad-spectrum antibiotics, and the hospital treatment. Thrombocytopenia is the risk of bleeding from the nose, stomach, and uterus. In the case of the reduction in the number of thrombocytes, it is necessary to carry out immediate blood transfusion, and the appointment of medicine for the restoration of blood compounds. Myalgia and arthralgia (pain in the muscles and joints) appear two or three days after the chemotherapy. The pain may have different intensity and last from three to five days. Very often these side effects do not require treatment, but the patients may take non-narcotic analgesics.

Often, the patients lose appetite that may cause weakening of the body and the exhaustion of the organism. Therefore, special attention should be paid to the observance of the diet. It is better to feed the patient with small fractional portions several times a day. Along with a decrease in appetite, a patient may face the problems of bowel activity. There may take place diarrhea or constipation. When the patient suffers from diarrhea, the diet should be high in calories, rich in protein and vitamins. Meat is permitted only if it is boiled and shredded: steam cutlets, dumplings, souffles. The juice of blueberries, cranberries, and fresh fruit allow enriching the organism with the vitamins and microelements. It is recommended to avoid juice from plums, apples, grapes, peaches. When cancer patients suffer from constipation, they need to consume more of fiber. In this case, it is recommended to use glycerin suppositories, salt or herbal laxatives. Due to this fact, a healthy diet is one of the most important factors for the prevention of digestion problems.

Despite the significant advance in the diagnosis and treatment of cancer, the percentage of patients with the advanced forms of cancer is very high. Unfortunately, sometimes the patients are forced to hear from the oncologist that the patient that they need the palliative care. The palliative aid is primarily directed towards abolishing the symptoms of the disease: the disorders of the mental and emotional condition, pain, shortness of breath, edema, and gastrointestinal disorders. Clinical experience shows that correct carrying out symptomatic treatment can keep the patient`s life for a few months and even years. Thus, it is necessary to provide the patients with adequate palliative care to reduce their sufferings and to improve the general quality of life to the maximal possible extent.

Conclusion

Cancer is one of the most complicated diseases for the modern era. Even in the developed countries there do not exist methods that would guarantee to overcome the disease. For cancer care, it is necessary to combine efforts of different medical personnel. A nurse should deliver the medical and psychological care to the patient, to monitor his/her condition, to communicate with families, and to carry out the research. It is also necessary to monitor the possible side effects to avoid further complications of the treatment.

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